Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital

Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerousand early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomlycame to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) wereexamined by VIA. Detection tion or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituteda positive VIA. Those who had abnormal results in screening test those who had clinically suspiciouslesions were sent for colposcopic evaluation (n= 442) directed biopsy were taken from colposcopicallysuspected areas (n=214). The final diagnosis was based on histology . Results: Out of 5593 patients, 442(7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) werenormal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) hadcarcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5(2.33%) had carcinoma in-situ 17 cases (7.94%) had invasive carcinoma. Besides to find out the pre-dictable factors of cervical lesions data have been collected from VIA positive coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and fami-ly history of cancer. Age of (46 %) and 40 % (177) women respectively . More than half of the patients (62%) were experienced withtheir first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty fourpercent patients used OCP and barrier among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9%(table 1) Conclusion: In our study detection of dif ferent grades of intraepithelial lesions (CIN-I, CIN-II,CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable fordetection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow uptreatment and epidemiological studies of cervical cancer.